Healthcare Provider Details

I. General information

NPI: 1255974796
Provider Name (Legal Business Name): COURTNEY HOFFER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 POND PARK RD STE 308
HINGHAM MA
02043-4354
US

IV. Provider business mailing address

2 POND PARK RD STE 308
HINGHAM MA
02043-4354
US

V. Phone/Fax

Practice location:
  • Phone: 781-740-7840
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN276686
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: